What is the Beers Criteria?
Originally developed by Mark Beers, MD, in 1991, the AGS Beers Criteria is a list of medications considered potentially inappropriate for older adults due to a higher risk of adverse effects. The criteria, updated regularly by the American Geriatrics Society (AGS), is a cornerstone of safe medication prescribing for the geriatric population. The intent is not to forbid the use of these medications entirely, but to ensure they are used with special caution and consideration.
The Beers Criteria card: A quick reference
The Beers Criteria card is a physical or digital pocket-sized tool derived from the comprehensive criteria. Designed for easy use by busy clinicians, it provides an at-a-glance summary of the most critical recommendations. This handy reference allows doctors, pharmacists, and other healthcare providers to quickly cross-reference medications during a patient consultation, minimizing the risk of a potentially inappropriate prescription.
The Five Categories of the Beers Criteria
The AGS Beers Criteria organizes potentially inappropriate medications into five distinct categories. These classifications provide a structured approach to assessing medication risks for older patients. It's an important framework for anyone wondering, “What is the Beers Criteria card and what does it contain?”.
- Medications to be avoided by most older adults: This category lists drugs that are rarely, if ever, appropriate for use in older adults. These medications have a high risk of adverse effects that almost always outweigh any potential benefits.
- Medications to be avoided in older adults with specific health conditions: Certain diseases or syndromes can be worsened by particular medications. This list helps healthcare providers avoid drugs that could exacerbate existing conditions.
- Medications to be used with caution: Some medications require careful monitoring and assessment, as the potential risks may be less certain or may be acceptable in specific circumstances. The benefits and harms must be weighed carefully by the clinician.
- Potentially inappropriate drug-drug interactions: This section highlights combinations of medications that can be particularly dangerous when taken together by an older person. It serves as a crucial reminder for polypharmacy management.
- Medications to be dose-adjusted based on kidney function: As the kidneys become less efficient with age, some drugs can build up to toxic levels in the body. This category provides guidance on adjusting dosages for patients with reduced renal function.
The Importance and Limitations of the Criteria
While the Beers Criteria card is an invaluable tool, it's essential to understand its proper application. The AGS emphasizes that the criteria should not be used in a punitive manner or as a rigid set of rules. Instead, it should serve as a starting point for dialogue and shared decision-making between a patient and their healthcare provider. The criteria do not account for every individual circumstance, patient preference, or unique health condition. For instance, a medication on the list might still be the best choice for a specific patient, especially in hospice or palliative care settings where treatment goals are different. The healthcare provider’s experience and the patient’s health status are always paramount.
How the Beers Criteria is Updated
To remain current with the latest medical research, the AGS periodically revises the criteria, typically every three years. This process involves a panel of experts who systematically review thousands of clinical trials and research studies. Based on the evidence, the panel may add, remove, or modify existing medications on the list. The latest revision was in 2023.
Engaging with the Beers Criteria as a Patient or Caregiver
Patients and caregivers play an active role in medication safety. The Health in Aging website, a resource from the AGS, offers consumer-friendly information about the criteria. By keeping an updated list of all medications, including prescriptions, over-the-counter drugs, and supplements, patients can better discuss their full regimen with their doctor.
Medications for Young Adults vs. Older Adults
Here is a comparison of medication considerations for different age groups.
| Aspect | Considerations for Young Adults | Considerations for Older Adults |
|---|---|---|
| Metabolism | Generally efficient, liver and kidneys function at peak capacity. | Slower, less efficient metabolism due to changes in liver and kidney function. |
| Polypharmacy | Often take fewer medications for single, acute conditions. | Frequently take multiple medications for various chronic conditions. |
| Side Effects | Predictable side effect profiles and tolerance. | Higher sensitivity to side effects, potentially experiencing cognitive impairment, falls, or confusion. |
| Drug-Drug Interactions | Lower risk due to fewer medications taken concurrently. | Significantly higher risk due to polypharmacy. |
| Goal of Treatment | Often curative or focused on managing short-term illness. | Often includes managing chronic conditions to improve quality of life and function. |
Conclusion: A Tool for Safer Prescribing
The Beers Criteria card is an essential tool for promoting medication safety in older adults. By serving as a portable guide to the AGS's comprehensive recommendations, it enables healthcare providers to make more informed prescribing decisions. For patients and caregivers, understanding what the Beers Criteria card is empowers them to engage in meaningful conversations with their doctors about the potential risks and benefits of their medications, ultimately contributing to healthier and safer aging.
Learn more directly from the source by visiting the American Geriatrics Society website.
